I hear a patient set of a bed alarm, and sprint into the room. A little old lady looks up as I come in, and says, “Why are there all these snakes on the floor?!”

I look around, and there is nothing that could even conceivably be mistaken for a snake. “What snakes?”

“Those snakes!” The little old lady points at the bare floor. “There aren’t any snakes here.” “Yes, right there!” Again waving at the empty floor.

“I think you’re hallucinating, there aren’t any snakes.” “Oh, that’s a relief!” And the little old lady relaxes back in her bed and closes her eyes. “Ok, good night. I’ll check on you in a bit. Hit your call light if you need anything.”

“Good night!”

We had a similar conversation about every hour throughout the night – whether it was snakes, bats, bugs, or rats. She also had a great conversation with her mother (my patient was in her 90’s). UTIs are no good in the elderly! At least she was pleasantly confused.